Live Your Dream Reference Form

This form is to be filled out by people who have been asked to provide a reference for an applicant to our Live Your Dream Award.

Print the reference form and take your time in answering the questions as thoroughly and accurately as possible. When you have finished answering the questions, you can either scan the reference form and email it to Soroptimist International of Victoria Westshore (lyd@sivw.ca) or you can use the form as a reference guide to filling out the online reference form below.

NOTE: The online reference form does not save and must be completed in one sitting.

Since 1972, the Soroptimist Live Your Dream: Education and Training Awards have provided women with resources to improve their education, skills and employment prospects so they can live their dreams. Eligible applicants are women who:

Provide the primary financial support for their dependents (dependents can include children, spouse, siblings and/or parents).

Have financial need.

Are enrolled in or have been accepted to a vocational/skills training program or an undergraduate degree program.

Are motivated to achieve their educational and career goals.

Reside in the Capital Regional District.

Have not previously been the recipient of a Soroptimist Women’s Opportunity Award or Live Your Dream Award.

Do not have a graduate degree.

Are not Soroptimist members, employees of Soroptimist International of the Americas or immediate family of either.

In order for applicants to be fairly judged, reference forms are required. Please do not submit other forms of references (such as a letter). They will not be
considered as part of the application.

Please use your personal knowledge of the applicant to respond to the following questions:

1. How long have you known the candidate and in what capacity (employer, school instructor, friends, etc.)?*

2. Please rate the candidate in the following areas, based upon your knowledge of her achievements and strengths. A score of "1" means that you "strongly agree" with the statement; a score of "5" means that you "strongly disagree" with the statement.

A. The applicant has clear goals.*

1. Strongly Agree

2. Mostly Agree

3. Somewhat Agree

4. Mostly Disagree

5. Strongly Disagree

6. Don't Know

B. The applicant is motivated to reach these goals.*

1. Strongly Agree

2. Mostly Agree

3. Somewhat Agree

4. Mostly Disagree

5. Strongly Disagree

6. Don't Know

C. The applicant has demonstrated she is responsible.*

1. Strongly Agree

2. Mostly Agree

3. Somewhat Agree

4. Mostly Disagree

5. Strongly Disagree

6. Don't Know

D. The applicant would be an inspiration to others.*

1. Strongly Agree

2. Mostly Agree

3. Somewhat Agree

4. Mostly Disagree

5. Strongly Disagree

6. Don't Know

3. Please tell us what you believe to be the applicant's particular strengths in her personal, educational or professional life. If you can, give examples of particular accomplishments.*

4. What is your knowledge of the applicant's educational goals and her progress toward achieving these goals? Consider any barriers or difficulties she has overcome.*

5. Is there any additional information we should know about this applicant in regard to this award program?*